Surgical appliance



SURGICAL APPLIANCE Filed Aug. 14, 1944 COLLAR T/:JUE EL. l O INVENTOR: F15/@NAND l//sr/eE/CH,

/7 s ATTORNEY;

Patented Mar. 6, 1945 UNITED STATES PATENT OFFICE y aanpastj j SURGICAL Arruanon Fernand Vlstrech, Great Neck,N. i Application August 14, 1944, serrano'. 549,3034

' scanne: (01.129325) This invention relates to a means for use .in connection with stopping of bleeding, more particularly in connection with surgical operations which are performed in such elds where the usual method of tying blood. vessels is technically diilicult.

The control of the bleeding which .occurs during a surgical operation, as :for instance, `when referred to and illustrated in the accompanying Y drawing, but it is to be understood that changes,

removing the tonsils, is .a very important `part of such an operation.y The routine procedure consists of applying pressure in the, fossae4 by means of gauze Sponges and undoubtedly in many cases this will suffice to secure stoppage of bleed--v ing. Nevertheless, even though cessation of the bleeding has been achieved, itis a matter of chance whether a late bleeding will not occur during'the early convalescence The `length of time `ever which this pressure is to be applied is usually not less than three minutes,y but often considerablymore.V Often, too.,V the `bleeding will not stop by simple pressure, and other methods must be resorted to.

The, method most frequently used is clampingA the bleedingpoints and `applying avcatgut liga ture on them. This may bean adequate way of controlling the bleeding, but `the Yligation itself requires special skill of a high degree. 4lilvery I so often it .happens that no sooner the artery forceps is removed from'its position the ligature will lose its hold underthe eyesof thesurgeon',

because it wasV not suioiently tight, or the cat gut tears while `being tightened The whole procedure must Vbe done over andv often enough the situation becomes quitey serious. The suture is hardly an easier procedure. v

Besides the difficulty of these methods, the fact that considerable time is spent in stopping the bleeding, makes a more efcient method l'of ligation in the tonsillar fossae highly desirable.`

Efficiency and speed in ligation is just as much, if notl more, needed in late hemorrhages after tonsillectomy and other surgical operations.

My invention has for a further object to expedite and satisfactorily apply',vby force, an automatically constrictibleligature relative to a bleeding point to stop bleeding. y i y K My linvention has for its,A further object to provide, in a manner as hereinafter set forth, -a comparatively simple device for applying an auto.. matically constrictible ligature for the purpose of stopping bleeding.l

Embodying the objects aforesaid and others which may hereinafter appearfmy invention consists of the novel yconstruction,combination and arrangement ofy parts as willv bemore specifically tion of that portion of the device ends of the handles, and

. handles i3, I4, as is well known in this art. The forceps have upper and lower termination i tapered contour.

device, Y

Figure B'is a fragmentary view in side eleva#` tion illustrating the position of 'the partsk for receiving a ligature, l f `f Figure 4 is a front elevation of the ligature;

Figures 5, 6 and 7 are fragmentary vewsln side elevation of the device showing the steps employed when applying a ligature and with Figure '7 upon an enlarged scale and partly ln section, Y

`Figure 8 is a diagrammatic view illustrating a i bleeding point provided with a ligature,

Figure v9 is a view looking towards` the opposite sides ofthe device or appliance `withthe' ligal ture omitted, y Figure 10 is a' fragmentary view, upon an enlarged scale in side elevation land partly in secat the upper Figure 11 is a section on line Il, Figure 10.` Referring to the drawing, i0 indicates a scissor acting forceps of the well known so-called alligator'type in which an .upper element Il may be caused to slidably move on and with relation to a lowerY element l2, by the operation ofthe lips or jaws l5, I6; said jaws in one relative movement of themembers ll and l2 being tghtly .closed upon one another, as illustrated in Fis* ures 3 and 5, while in the kopposite relative Inovementof thevtwo elements, they will openup as shown in Figure 6'. 'The jaws I5, 1 I6 arelso formed that when they are closed they provide theforceps with a forward terminal portionof hereinafter referred to as superimposed `supporting elements. `The jaws-l5, l6-will beherein-v after referred to as combined expender`A and "grip members. f .i A slidable pushing or operating roclll is closely applied -along one of the sides of the` elements The elements Il, l2v will be y or members II, I 2.` Therod I1, intermedateits ends is secured to the outer faces of spaced, aligned, split, resilient, substantially Ovoidalshaped Icombined guiding and coupling members I8, I9 which overlap and grip the elements I I, I2. guides for the rod I1, but also act as couplings for slidably connecting rod I1 to said elements II, I2. The rforward terminal portion of the rod I1 is secured to the outer face of a vforcing sleeve 20 adapted to be normally mounted on the elements II, I2 rearward of the jaws I5, I 6 or the tapered forward terminal portion of the forceps formed by the jaws.

beyond the hinge or pivot of the jaw I; A`

handle or loop-like grip 22-is at the rear end ofg The members I8, I9 not only constitute the rod I1. The ligature which is applied by the device consists of a comparatively thin resilient rubber disc 23 having a minute axially arranged opening 24. The disc 23 possesses a characteris- .zor

tic of being automatically constrictible when'apv plied Vat the bleeding point. When the device applies a ligature relative to a bleeding point which is difficult of access, byy

Way of example, after a tonsillectomy and with the bleeding point indicated at 25, Figure 1, the disc willbe pulled 'over the closed jaws I5, I6 toan extentV to abut the forcingA sleeve 2D, as shown by Figure 5, and when'so positionedthe wall of the opening 24 will 'be stretched. After disc 23 is in the position shown by Figure 5, the

jaws are opened and positioned about anddisposed in relation to grip the outer portion of the tissues. surrounding the bleeding point, Aas is shown by Figure 6. With the jaws in the position shown in Figure 6, the rod I1 isthen pushed forwardly carrying the sleeve therewith, whereby the latter will'force the disc 2 3olT the jaws to a position to surround and tightlyrgrip together that portion of the tissues inwardly of the portion gripped by the jaws and thereby stop bleeding. The position ofthe disc will then be as shown ley-Figure 7. The forceps are then reare gripped by the jaws, and the disc 23 will then appear as Shown by Figure 8.

The operation for stopping is'effected in a very short time,fthat is to say, is expeditiously performed by a device in accordance with this invention. These self-holding ties or ligatures,.if

l moved from that portion of the tissues, which y row 35,the elements'or membersV II andV I2 will have an opposite relative motion, that is, the

i element I I will move outwardly towards the han- 2,371,os2 l f' si The handle 29 is integral with'the lower element or member I2, and handle 3lvhasl alpivot 3| and an extension 32 engaging at its rounded upper end or the upper sliding element or member II. When the two handles 29 and 30 are forced towards each other, as indicated by the arrow 33,` the handle 29 with the lower element or member I2 will rock and slide on the pin 3i p -and the upper element or member I I will be causedto Lslide forwardly towards the jaws I5 and I6, as indicated by the arrow.A 34, thereby causing jaw I5 to rock on the pivot 2 Ia and close .con .l'aW |6- 1 The sleeve 20 is pulled over the jaws I5, I6 when the jaws are.

closed, to an extent to be positioned. rearwardly In a reverse manner, whenV the handles 29 and 39' are caused to separate as indicatedby the artom withv the upper Vend of passage 36.A The member I2 is also formed with a .pair of spaced aligned vinclined cutouts 36 in its sides, which communicate with the passage 36 andopeniat the bottom'edge of member I2.' AThe handle 3U hasv a reduced upper end portion which constitutes the extension 32. vThe latter passes `through the passage l36 into the cutout 31.` The `reduced upper 'end portion of the handle 3U forms the latter with a' pair of shoulders 39 which ride against the bottoni edge of the element I2. The. extension 32'has'a rounded upper end of disc-like form vwhichconstitutes a head '49 which is arranged in the cutout 31. The extension 32 intermediate its ends'is formed witha reduced part providing a neckvv 4I of less width than the diameter of said head and cutf out'. The neck 4I merges into the bottom of the head and `is'arranged between 'the ends 4of the properly applied, will remain in position for a The patient usually does not know of their presence and they can be thrown off after serving their purpose.` without danger. I The eventualities of a late hem orrhage is practically eliminated.

They even may be swallowed The instrument may besterilized by boiling,

. but the ligatures must be soaked in alcohol.

The push rod may be removed from the forl ceps, as will be understood and the forceps taken apart asis known in the art, Vto effect a better 4 cleaning'and the same may be assembledin a 'similar 'obviouseasy manner for new. operation.

Limit stops 21, 28 are provided on the sliding member II to limit the inward and outward `shifting movements of .the sliding rod I1. VThe `upper jaw I5 is secured to the upper sliding'element or member I I at the pivot joint 2l, but `this jaw has a downward extension which 'is pivoted around the small pin 2 Ia in the lower elernent or member I2, with which the lower jaw I6 is'integral. v 'fl few days. They cause no discomfort whatsoever.

wall of cutout 31. Thehead 40, cutout 31, neck 4I and extension 32 correlate to connect the parts II land I2 together. The pivot pin 3|' is integral with and extends vlaterally from'opposite sides ofthe extension l32'.v Thev pin mounted in the cutouts 38. f

What Iclaim is: v

1. In a means for stopping bleeding of a part of the human body, a pair of superimposed upper and lower supporting elements, a pair of oppo- .sitely disposed tapered superimposed 'f combined expander and grip members capableof -tightly and'releasablygripping the outer portion of the tissues surrounding a bleeding point to arrest bleeding, one of said members being integral at its rear end with the forward end of said lower f element, theVv other of said members being pivotally connected at its r'earend to the forward end of said upper. element to the rear end of the'said'one member and aligned with said'upper element, an axially'apertured inherentlyV constrictible disc rele-asably mounted axially thereof on the rear ends of and having its laperture expanded by said members, said disc releasably` against said members, interengaging op binding positely shiftablemeans at the rear ends Iof said elementsfor imparting a forward and ay rearv 3l l is slidably shiftable rod arranged in juxtaposition to one side of said elements and having its forward portion secured to said sleeve and providing when shifted forwardly for said sleeve forcing said disc over said members, while the diameter of the aperture of the disc gradulally decreases and off the forward ends of said members to encompass and tightly grip together tissues inwardly of said gripped outer portion of the tissues to stop bleeding while said members are in gripping relation with said outer portion, and a set of spaced, split, resilient couplers common to said rod and elements, secured to one side of said rod and overlapping said elements.

2. In a means for stopping bleeding of a part of the human body, a pair of superimposed upper and lower supporting elements, a pair of oppositely disposed tapered superimposed combined expander and grip members capable of tightly and releasably gripping the outer portion of the tissues surrounding a bleeding point to arrest bleeding, one of said members being integral at its rear end with the forward end of said lower element, the other of said members being pivotally connected at its rear end to the forward end of said upper element, to the rear end of the said one member and aligned with said upper element, an axially apertured inherently constrictible disc releasably mounted axially thereof on the rear ends of and having its aperture expanded by said membersy said disc releasably binding against said members, interengaging oppositely shiftable means at the rear ends of said elements for imparting a forward and a rear sliding movement to said upper element relative to said lower element for respectively moving said pivoted member towards and from said integral member, a sleeve mounted on said elements and normally disposed rearwardly of said members and disc, a forwardly and a rearwardly shiftable rod arranged in juxtapositionr to one side of said elements and having its forward portion secured to said sleeve and providing when shifted forwardly for said sleeve forcing said disc over said members, while the diameter of the aperture of the disc gradually decreases and olf the forward ends of said members to encompass and tightly grip together tissues inwardly of said gripped outer portion of the-tissues to stop bleeding while said members are in gripping relation with said outer portion, a set of spaced, split, resilient couplers common to said rod and elements, secured to one side of said rod and overlapping said elements, and a stop intermediate'the ends of and Iextended from the upper element, said stop being disposed between a pair of said couplers for limiting the extent of the shifting of said rod in one direction.

3. In a means for stopping bleeding of a part of the human body, a pair of superimposed upper and lower supporting elements, a pair of oppositely disposed tapered superimposed combined expander and grip members capable of tightly and releasably gripping the outer portion of the tissues surrounding a bleeding point to arrest bleeding, one of; said members being integral at vits rear end with the forward end of said lower element, the other of said members being pivotally conneeted at its rear end to the forward end, of said upper element, tothe rear end of the said one member, and aligned with said upper Y velements for imparting a forward and a rear sliding novement to said upper element relative to said lower element for respectively moving said pivoted member towards and from said integral member, a sleeve mounted on said ele-` ments and normally disposed rearwardly of said members and disc, a forwardly and a rearwardly shiftable rod arranged in juxtaposition toy one v side of said elements and having its forward portion secured tosaid sleeve and providingl when shifted forwardly for said sleeve forcing said vdisc over said members, while the diameter of the aperture of the disc gradually decreases and 

